Blood test, clotting time (PTT)
Facility: Dukes Memorial Hospital
Billing Code: 85730 (CPT)
- CPT Billing Code: 85730
- Insurance Median: $41
- Cash Discount Price: $97
- vs. Medicare Baseline: 6.82x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $6.01 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 682% of the Medicare baseline (a markup of 582%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $3 - $62 | 50% |
| Aetna | $4 - $92 | 67% |
| Department Of Veterans Affairs | $4 - $36 | 67% |
| Humana | $4 - $38 | 67% |
| Iu Health Plan | $4 - $38 | 67% |
| Managed Health Services | $4 - $78 | 67% |
| Medicare (plans) | $4 - $38 | 67% |
| Node Devoted Health Mcr Adv | $4 - $39 | 67% |
| Node Va | $4 - $94 | 67% |
| Tricare | $4 - $36 | 67% |
| UnitedHealthcare | $4 - $95 | 67% |
| In Dept Of Correction | $5 - $40 | 83% |
| Miami County Sheriffs Department | $5 - $40 | 83% |
| Node Pphp Mcr Adv | $5 - $41 | 83% |
| Caresource | $6 | 100% |
| Medicaid / KanCare | $6 | 100% |
| Mhs | $6 | 100% |
| Veterans Eval Services | $6 | 100% |
| Align Network | $7 - $62 | 116% |
| Lutheran Advanced Network | $7 - $58 | 116% |
| Lutheran Preferred | $7 - $155 | 116% |
| Lutheran Three Rivers Preferred Plus 150 | $7 - $58 | 116% |
| Node Lutheran Preferred Fixed 2 | $7 - $58 | 116% |
| Encore Work Comp In | $8 - $70 | 133% |
| Lutheran Three Rivers Preferred Plus 175 | $8 - $68 | 133% |
| Partners Direct Health Llc | $8 - $74 | 133% |
| Prime Health Services | $8 - $146 | 133% |
| Us Department Of Labor | $8 | 133% |
| Cigna | $9 - $194 | 150% |
| Lutheran Northwest Health Preferred | $9 - $78 | 150% |
| Physicians Health Plan | $9 - $90 | 150% |
| Three Rivers Preferred Plus | $9 - $78 | 150% |
| Work Comp | $9 - $78 | 150% |
| Php Freedom | $10 - $90 | 166% |
| Three Rivers Preferred | $10 - $87 | 166% |
| Amish Aid | $11 - $97 | 183% |
| Encore Kba Epo | $11 - $93 | 183% |
| Encore Ppo | $11 - $97 | 183% |
| Self Pay | $11 - $107 | 183% |
| Sagamore Health Network | $12 - $107 | 200% |
| Encore Kba Ppo | $13 - $116 | 216% |
| Consumer Life | $14 - $120 | 233% |
| Advantage Health Solutions | $18 - $161 | 300% |
| Encore Health Network | $18 - $159 | 300% |
| First Health | $18 - $155 | 300% |
| Multiplan | $18 - $157 | 300% |
| Encore | $20 - $175 | 333% |